Presentation
Severe dietary restriction - only eats weetabix. Unable to walk unsupported. Hip and knee pain.
Patient Data
Age: 5 years
Gender: Male
From the case:
Scurvy
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Bilateral and symmetrical signal abnormality of all visible metaphyses (including radius and ulna). Marrow edema of ischiopubic synchondrosis and ischium.
Case Discussion
The bilateral symmetrical appearances with the history of severe dietary deficiency would fit with severe hypovitaminosis C (scurvy).
This was confirmed biochemically. He was profoundly vitamin C, vitamin D and vitamin B12 deficient. Plasma vitamin C levels were <1 μmol/L (deficiency: <11.0 μmol/L; high: >250 μmol/L).
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